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Pain Research and Management
Volume 20, Issue 1, Pages 35-38
Original Article

Is Intra-Articular Magnesium Effective for Postoperative Analgesia in Arthroscopic Shoulder Surgery?

Tuba Berra Saritas,1 Hale Borazan,1 Selmin Okesli,1 Mustafa Yel,2 and Seref Otelcioglu1

1Anesthesiology and Reanimation Department, Necmettin Erbakan U Meram Medical School, Konya, Turkey
2Orthopaedics Department, Necmettin Erbakan U Meram Medical School, Konya, Turkey

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, a N-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements.

METHODS: A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg/mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times).

RESULTS: Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range.

CONCLUSIONS: Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.